What is sciatica?
What are the common causes of sciatica?
- Lumbar spinal stenosis. Spinal stenosis is a narrowing of one or more areas in your spine — most often in your upper or lower back. When the narrowing occurs in the lower spine, the lumbar and sacral nerve roots may be affected.
- Spondylolisthesis. This condition, often the result of degenerative disk disease, occurs when one vertebra slips slightly forward over another vertebra. The displaced bone may pinch the sciatic nerve where it leaves your spine.
- Piriformis syndrome. The piriformis muscle starts at your lower spine and connects to each thighbone (femur). Piriformis syndrome occurs when the muscle becomes tight or goes into spasms, putting pressure on the sciatic nerve. Prolonged sitting, car accidents and falls can contribute to piriformis syndrome.
- Spinal tumors. In the spine, tumors can occur inside the spinal cord, within the membranes (meninges) that cover the spinal cord, or in the space between the spinal cord and the vertebrae. As it grows, a tumor compresses the cord itself or the nerve roots.
- Trauma. A car accident, fall or blow to your spine can injure the lumbar or sacral nerve roots.
- Sciatic nerve tumor or injury. Sometimes, the sciatic nerve itself may be affected by a tumor or injury.
- Other causes. In some cases, your doctor may not be able to find a cause for your sciatica. A number of problems can affect your bones, joints and muscles, all of which could potentially result in sciatic pain.
What are the risk factors for sciatica?Risk factors for sciatica include health problems, lifestyle choices and inherent qualities, such as age or race, make it more likely you'll develop a particular condition. Major risk factors for sciatica include:
- Age. Age-related changes in the spine are a common cause of sciatica. You're likely to have some deterioration in the disks in your back by the time you're 40.
- Occupation. A job that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods makes you more prone to develop sciatica.
- Prolonged sitting. People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
- Diabetes. This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.
What is the prognosis of sciatica?
- Worsening symptoms. Pain, numbness or weakness may increase to the point that you can't perform your usual daily activities.
- Bladder or bowel dysfunction. People who have the cauda equina syndrome may become incontinent or have difficulty urinating even with a full bladder.
- Saddle anesthesia. This progressive loss of sensation affects the areas that would touch a saddle — the inner thighs, back of legs and the area around the rectum.
How can physiotherapy and massage therapy help sciatica?
Manual PhysiotherapyManual therapy for sciatica will depend largely on the assessment's findings of the cause of your symptoms. If stenosis is the cause, traction techniques will be performed acutely for pain relief, followed by mobilization to many of the surrounding vertebrae to gain mobility. The piriformis muscle can also be a cause, so manual treatment here will be focused on soft tissue release of the muscle, as well as joint mobilization in the ball and socket joint of the hip if there is early degenerative change there. It is important to us to also assess tension in any of the key musculature that the nerve travels through (i.e. calf and hamstring). If you have a herniated disc causing sciatica, physiotherapy can play a vital role in your recovery. There are some very important exercises and concepts that you should know. This first aid measure requires urgent care and a commitment to the things you need to do to resolve this problem. If not, the prognosis is often poor. Once acute pain improves, your physiotherapist can design a rehabilitation program to help prevent recurrent injuries. Rehabilitation typically includes exercises to help correct your posture, strengthen the muscles supporting your back and improve your flexibility. Your doctor should have you start physiotherapy, exercise or both as early as possible. It's the cornerstone of your treatment program and should become part of your permanent routine at home. Sciatic that is caused by trauma, and/or nerve compression from a bone spur and or herniated disc is a concern and requires urgent care by a doctor.
How can exercise and physical development help with sciatica?
Rehabilitation after a SciaticaAs the pain improves, physiotherapists can educate you about the things do and to avoid doing. They can advance you to a rehabilitation program of core strength and stability to maximize your back health and help protect against future injury.
- Flexion Dysfunction: If the cause of sciatic was do to a flexion disorder, lumbar extension exercises create an arch or lordosis in your back, which helps to alleviate pressure as the disc and reduce the size of the bulge. Walking is an excellent for this condition once the pain reduces. Many are able to resume to their previous running activity as it is an activity that maintains the spine in good alignment. The activity that will never be good for this condition is rowing, deadlifts, deep squats, and excessive amounts of sitting, bending, lifting, sit ups, gardening, and any movements which bend the hips toward your chest and or bend your trunk to your legs.
- Extension Dysfunction: If you sciatic was caused by an extension dysfunction, the relieving positions and postures will be towards neutral and flexion such as knees to chest and activities that bend the spine.
Physiotherapy and Physical DevelopmentThe final step is to establish a personal improvement health plan to continue to develop physically throughout your life. This is especially necessary after injury or an accident when you have become deconditioned. All of our staff have a combination of health sciences and sports sciences training, having dual training in both kinesiology and physiotherapy and allowing us to provide a biomechanical focus. Once you have recovered from your injuries, our therapists will perform a functional movement screen and analysis to identify individual muscle imbalances that are unique to your inherited structure, to your movement patterns, and to your goals and interests in living a healthy physical life. We develop a individualized program that focus on:
- Your specific imbalances and movement patterns at work, home, and those evident during the activities that you participate in.
- You structural and genetic posture and alignment characterizes and how they affect your interests to do activity etc.
- We look at the ergonomics specific to your workplace and home
How can low intensity laser therapy help sciatica?
Physiological effects of Low Intensity Laser TherapyWith LILT there is an increased production and release of:
- Endorphins which - natural analgesics
- Cortisol – a precursor of cortisone
- Growth hormone – instrumental in tissue repair
- ATP – improves and regulates cellular metabolism
- An increase in protein synthesis – collagen, DNA, fibroblasts
- A facilitated venous and lymphatic flow
- Increased angiogenesis – the elevation of oxygen saturation
- Enhanced immune response
What life style and self-care measures can you do for yourself with sciatica?
- Book an appointment with a Doctor. Seek a proper diagnosis and rule out any serious conditions.
- Book an Appointment with a Physiotherapist. Back problems leading to leg pain is often associated with poor posture during the years where age-related wear and tear occurs. To help prevent back pain, in standing keep your head centered over your spine, in a neutral position. In sitting, keep your feet on the ground, your hips tilted forward creating an arch in your low back, keep your head in neutral such that your ear is in line with your shoulder and centered.
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